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Q. How to treat a child with a cough without fever when X-ray chest is normal?

Answered by
Dr. Faisal Abdul Karim Malim
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 23, 2022

Hello doctor,

I am attaching the reports of a three-month-old male child. A few days back, he was hospitalized for chest conjunction and got discharged. Today he had a chest X-ray, and his SpO2 is 95 %. Now there is only coughing without any fever.

The doctor has advised antibiotic Novapime - 0.25 g - ten injections, antiallergic syrup - Childryl, and a nasal drop - Nosimore-S.

After seeing his present X-ray, the doctor wants him to get admitted, but the caretakers are not in a position to spend money, and they contacted me to get valuable suggestions.

Please suggest a better protocol.

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Hello,

Welcome to icliniq.com.

I have gone through all the reports (attachments removed to protect the patient's identity). As per your description, I would definitely suggest looking into the following:

1. It is quite possible the child may be having reflux issues and not any respiratory system issues. You will have to check for crepitations (crackling sound while breathing) or wheezing on physical examination, check weight to see for any significant weight loss (more than 10 percent), and cardiac evaluation for murmurs (whooshing sound in the heart). And also have to know whether the child is more comfortable in a lying down position or in a picked-up position. The X-ray does not seem to show any pneumonia patch. However, the X-ray picture with a background light is not clear, so I cannot comment more on the same.

2. If the child is suffering from reflux, I would suggest starting the syrup Perinorm (Metoclopramide Hydrochloride) thrice a day and syrup Aciloc (Ranitidine) twice a day - doses as per the weight of the child.


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